IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v22y2025i7p1040-d1690920.html
   My bibliography  Save this article

The Nicotine Metabolite Ratio and Response to Smoking Cessation Treatment Among People Living with HIV Who Smoke in South Africa

Author

Listed:
  • Chukwudi Keke

    (Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA)

  • Limakatso Lebina

    (Africa Health Research Institute, Somkhele, Myeki 3935, South Africa)

  • Katlego Motlhaoleng

    (Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg 2193, South Africa)

  • Raymond Niaura

    (School of Global Public Health, New York University, New York, NY 10003, USA)

  • David Abrams

    (School of Global Public Health, New York University, New York, NY 10003, USA)

  • Ebrahim Variava

    (Klerksdorp Tshepong Hospital Complex, Matlosana 2574, South Africa)

  • Nikhil Gupte

    (Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA)

  • Jonathan E. Golub

    (Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA)

  • Neil A. Martinson

    (Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg 2193, South Africa
    Johns Hopkins University Center for TB Research, Baltimore, MD 21231, USA)

  • Jessica L. Elf

    (Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA)

Abstract

The nicotine metabolite ratio (NMR) has been informative in selecting treatment choices for nicotine dependence and increasing treatment efficacy in Western settings; however, the clinical utility of the NMR among smokers in low-resource settings remains unclear. Prospective analysis was conducted using data from a randomized controlled trial of smoking cessation among adults living with HIV, to examine the association between the NMR and response to smoking cessation treatment. NMR was assessed using bio-banked urine samples collected at baseline. Self-reported smoking at 6 months was verified using a urine cotinine test and exhaled breath carbon monoxide (CO). We found no associations between the NMR and smoking abstinence (adjusted risk ratio (aRR) = 0.82; 95% CI: 0.45, 1.49; p = 0.53). No evidence of effect modification by treatment conditions was observed on the multiplicative scale (aRR = 1.17; 95% CI: 0.32, 4.30; p = 0.81) or additive scale (adjusted relative excess risk due to interaction (aRERI) = 0.10; 95% CI: −1.16, 1.36; p = 0.44). Our results suggest that the NMR may not be a viable approach for selecting smoking cessation treatment in this setting, given the minimal variability in our sample and racial/ethnic makeup of this population.

Suggested Citation

  • Chukwudi Keke & Limakatso Lebina & Katlego Motlhaoleng & Raymond Niaura & David Abrams & Ebrahim Variava & Nikhil Gupte & Jonathan E. Golub & Neil A. Martinson & Jessica L. Elf, 2025. "The Nicotine Metabolite Ratio and Response to Smoking Cessation Treatment Among People Living with HIV Who Smoke in South Africa," IJERPH, MDPI, vol. 22(7), pages 1-11, June.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:1040-:d:1690920
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/22/7/1040/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/22/7/1040/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Emmanuel Peprah & Mari Armstrong-Hough & Stephanie H. Cook & Barbara Mukasa & Jacquelyn Y. Taylor & Huichun Xu & Linda Chang & Joyce Gyamfi & Nessa Ryan & Temitope Ojo & Anya Snyder & Juliet Iwelunmor, 2021. "An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa," IJERPH, MDPI, vol. 18(6), pages 1-12, March.
    2. Chukwudi Keke & Zane Wilson & Limakatso Lebina & Katlego Motlhaoleng & David Abrams & Ebrahim Variava & Nikhil Gupte & Raymond Niaura & Neil Martinson & Jonathan E. Golub & Jessica L. Elf, 2023. "A Cross-Sectional Analysis of the Nicotine Metabolite Ratio and Its Association with Sociodemographic and Smoking Characteristics among People with HIV Who Smoke in South Africa," IJERPH, MDPI, vol. 20(6), pages 1-8, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alissa C. Kress & Carlen Stadnik & Masauso Moses Phiri & Fastone M. Goma & Evelyn Twentyman, 2022. "Tobacco Use among HIV-Positive and HIV-Negative Women and Men in Zambia—Demographic and Health Survey, 2018," IJERPH, MDPI, vol. 19(7), pages 1-16, March.
    2. Emmanuel Peprah & Bronwyn Myers & Andre-Pascal Kengne & Nasheeta Peer & Omar El-Shahawy & Temitope Ojo & Barbara Mukasa & Oliver Ezechi & Juliet Iwelunmor & Nessa Ryan & Fatoumata Sakho & John Patena , 2022. "Using a Syndemics Framework to Understand How Substance Use Contributes to Morbidity and Mortality among People Living with HIV in Africa: A Call to Action," IJERPH, MDPI, vol. 19(3), pages 1-12, January.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:1040-:d:1690920. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.